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AUSTRALIA, like many countries, has a big problem with alcohol.
However, even more so than in some other countries, alcohol is very much a part of the Australian way of life. It is front and centre. It is tradition.
Alcohol is all around us — television, newspapers, magazines, rock concerts and festivals, major sporting events, and even local sporting events.
Drinking, and drinking heavily, is apparently a part of growing up Australian. At least that is how it is promoted to our young people through advertising, marketing and social media.
More than half of Australian drinkers consume alcohol in excess of the recommended intake and one in five Australians drink alcohol at a level that puts them at risk of lifetime harm for injury or disease.
The social appeal of alcohol is on constant public display. Sadly, the harms — the domestic violence, child abuse, street violence, drunken and antisocial behaviour, the road accidents, the misadventures, the damage to unborn babies, families and communities, and the deaths — are too often hidden from view.
Doctors see the tragic consequences of excessive alcohol consumption in their consulting rooms, hospitals and operating theatres every hour of every day.
We need to change Australia’s drinking culture — the health, social and economic burden caused by alcohol is substantial and unacceptable.
The AMA is not talking about banning alcohol or forcing people to stop consuming alcohol altogether. As a society, we need to have a mature national debate and develop a more responsible attitude to alcohol. This requires strong national leadership.
The recent AMA National Alcohol Summit highlighted the harms, and proposed solutions.
Alcohol-related harms take many forms, some unexpected. For example, the latest survey of alcohol-related harm in hospital emergency departments by the Australasian College of Emergency Medicine showed another dark side of alcohol misuse — violence against doctors, nurses and other patients from people who turn up in emergency as a result of excessive alcohol use.
Excessive alcohol consumption is an issue that deserves a nationally consistent response and a national strategy. Spending money and making announcements in an ad hoc way is not effective.
This is not to take anything away from individual initiatives but, if not supported and not part of an overarching theme, what do they achieve?
This is not an “us against them” scenario, but our society does face barriers and there are often strong vested interests. The alcohol industry is powerful, sophisticated and it has money … and political influence.
Small amounts of money spent on education and campaigns in one area can easily be swamped by industry spending on marketing and promotion. The industry has media influence too. It spends a lot on advertising and social media, which appeals to young people.
This influence must be met head on by our federal government.
There are many practical ways for the government to respond and lead. Spending on public education and campaigns is one important example. Regulation is another.
Simple changes can be made that are very cost-effective, such as mandating labelling on alcohol products, which should include health warnings, especially for fetal alcohol spectrum disorder (FASD), and nutritional information such as energy and calorie content.
Alcohol-related harms can only be effectively tackled through a nationally led strategy of high-impact campaigns to change behaviours and address our unhealthy drinking culture, backed by effective regulation, and early intervention and treatment.
The AMA has called on the government to develop an ambitious, comprehensive, and world-leading national alcohol strategy, to be funded and implemented from the 2015 federal Budget.
Without government leadership, commitment and coordination, it will be left to the doctors, nurses, social workers, counsellors, charities and others to continue to mop up the devastation caused by alcohol in Australia.
In the meantime, the AMA will highlight every road fatality, every bashing, every child with FASD, every tragedy that arises from our unhealthy drinking culture, to remind the government to take its rightful role in this battle.
Associate Professor Brian Owler is the federal president of the AMA.
All presentations and details of the recent AMA National Alcohol Summit are available at ama.com.au/alcoholsummit
This is a great discussion, thanks to everyone who has commented so far.
There are already some wonder public health programs in existence that are working hard to address the problems in ways that I think most of you would consider “moderate”. My favourite is Hello Sunday Morning.
https://www.hellosundaymorning.org/?utm_source=adwords&gclid=CLuD4vqngMICFUyUvQod7RQApQ
It’s not about absteinance or law reform but rather shifting the culture around drinking for young people. Helping them set healthly goals including a period without drinking to help them get their heads clear and seperate binge drinking from a good time out.
This discussion must not be allowed to be subverted by nanny-staters or problem drinkers with dependency issues.
Alcohol is embedded in our culture and it is entirely appropriate that it remain so. Alcohol consumed responsibly is pleasurable, a social lubricant, essentially harmless and in some formulations is increasingly seen to offer some health benefits when consumed in moderation. That some people are incapable of this moderation is not in dispute, but there is no place for wholesale penalisation of the many because a few are lacking in judgement, willpower or genetic capacity to handle alcohol.
The challenge is to convert research about problem drinking into management strategies for those that require them.
Alcohol is a toxic mind-altering drug that is deeply imbedded in our culture. Should it be?
“If you drink and drive, you are a bloody idiot!”
“If you drink a bit, you are a bit of an idiot!”
My name is Max – I’m an alcoholic. I have not consumed alcohol since joining AA on 5 November 1980. My addiction to alcohol saw me sacrifice a home and a family, two professional careers (one in neurophysiology), trustworthiness, respectability, and very nearly my life. Worst of all, I became consumed with self-hatred and considered myself an evil monster worthy only of a vile death. I wanted pity, but reviled it; I wanted rejection, but I condemned it.
Aversion therapy availed me not – included were threats, and ultimately divorce from my marriage, threats, and ultimately “voluntary” resignation from high school teaching, my 2nd career, and, in the last 5 years of my drinking, abyssmal hangovers with violent, debilitating vomiting. Like most reckless personalities, I viewed alcohol-related warnings as “that wouldn’t happen to me”, and eventually “I don’t care, I deserve it”.
Professional bodies gave me opportunities to invent excuses, while I cunningly avoided the truth, the reasons. The truths were that I believed that I was uniquely evil and I wanted to drink to oblivion – I was terrified of reality and I would not accept help. Shame and guilt were the constant companions whose presence was inversely related to my blood alcohol content. Similarly, grand mal seizures.
When I was sick of being sick, when I sincerely wanted help, I found that AA, friends and family, doctors were overwhelmingly supportive and encouraging.
Dr Sequin, thank you for your excellent observations – I believe that you are on the right track. Dr Owler, thank you for the article.
Alcohol is a drug. Ingest it, and the body recognises it as a toxin and responds accordingly. The problem is that alcohol adversely affects only a proportion of the population directly.
Some of us are more prone to become addicted to its effects than others. Often those who are more prone also have poorer self regulation. Education has little impact on these individuals. They fall prey to their impulses, thinking that they, like everybody else, can drink in moderation. But they can’t.
Alcohol addiction has flow-on effects which debilitate those who live with and love these individuals. Yet drinkers often have no awareness of both its effects on them or on those around them. It’s likely that the ubiquitous presence of this drug in our society disrupts far more lives than we think. Those living with a drinker often feel shame and hide the problem, while those who are unaffected enjoy the luxury of ignorance and of judgement and idealism.
We do not have to invent the wheel. We need only look to Norway and Sweden for models which have already been extensively researched as only the Scandinavia seem able to do.
Dear Colleagues – I am an owner of Restaurants, Pubs and Discos – I am also a Psychiatrist – not only am I likely to be biased, I am definitely conflicted.
Contrary to understandable assumptions of crass profiteering, the vast majority of Licensees are normal, decent types who prefer to dispense their wares responsibly with the important proviso that doing so doesn’t put them out of business altogether.
Liquor licensed premises are on the front line of suffering the negative effects of badly behaved and intoxicated patrons – damage, injury, excessive security and insurance costs, even prosecution for events outside their control. I’m confident that as a group Licensees would enthusiastically welcome for young Australians to ‘drink differently’.
Perhaps a new, more positive and less judgemental approach would be refreshing and effective in bringing about replacemant of the old ‘drink-to-get-drunk’ culture. The current approach is school-masterish and clumsy, inconveniencing the innocent majority of moderate, reasonable socialisers disproportionately to it’s proper target group of over-users. As usual, the majority paying for the sins of the few.
Does anyone in the medical community recognise any benefit to a society that allows alcohol? Until the potential benefits if any are agreed, recognised and freely allowed it will be difficult to get the industry fully onside to regulate constructively against the excesses.
“…something totally in our government’s control”. Really Lou?? If true, be afraid; be very afraid.
Australian LIves were lost in the disastrous plane crash over the Ukraine recently. People were horrified everywhere. Everyone from the Prime Minister down was emotionally distressed. Publicity was huge, special cermonies, life stories and photos of the victims appeard daily in the media.
Now compare that with all the innocent lives lost every day due directy to alcohol and how very little is done about it, but just accepted . We couldn’t prevent the Ukraine incident but here is something totally in our government’s control.
Thank you Brian Owler, you make me proud to be a member of the AMA.
Interesting that the need for a consistent message is stressed.
How then to reconcile the contrast between alcohol, where we are increasingly restricting access and sales via opening hours limitations and prosecuting drunken behaviour – prohibition-lite – versus drugs, where we decry the ‘war-on-drugs’ and urge decriminalisation?
I have a son who is in year 10 and I found that drug abuse/harm is discussed widely at his school but alcohol in comparison is overlooked. Alcohol awareness (i.e. its impact on brain developement and social side effects) should be discussed at school. It is at this `most impressionable age’ where they mimic adults and bow to peer pressure. It is also at this age where they can be taught to think for themselves by being given all the facts and data on alcohol.